Silicone Survivors: Women's Experiences with Breast Implants, and: Silicone Spills: Breast Implants on Trial (review)

Silicone Survivors: Women's Experiences with Breast Implants by Susan M. Zimmerman. Philadelphia, PA: Temple University Press, 1998, 225 pp., $19.95 paperback.

Silicone Spills: Breast Implants on Trial by Mary White Stewart. Wesport, CT: Praeger, 1998, 223 pp., $26.95 hardcover.

It took motherhood and menopause before I truly appreciated what breasts mean to women. Before lactating and going through the myriad of bodily changes associated with midlife, I was so small-breasted that I could not fully appreciate why this part of the female anatomy was so precious. And only once before coming into my own fullness did I begin to imagine what the trauma of mastectomy was about; that was the first time I heard of mastectomy referred to as amputation.

In Silicone Survivors: Women's Experiences with Breast Implants by Susan M. Zimmerman, and Silicone Spills: Breast Implants on Trial by Mary White Stewart, there is no doubt about the importance of breasts in women's lives. Nor is there any doubt about the risks, and the horrors, of silicone implants, whether for cosmetic or reconstructive reasons. (Cosmetic purposes include enhancing the shape or size of the breast, correcting asymmetry, and reducing post-partum sagging. Reconstruction refers to the replacement of one or both breasts after mastectomy).

Susan Zimmerman, a medical sociologist, set out to answer a set of specific questions: How had women arrived at the decision to have surgery to enhance or reconstruct their bodies; how had implants affected their lives; and how were they coping with the medical uncertainty surrounding silicone breast implants? In her own words:

Given the meanings attributed to breasts in our culture, what life experiences lead women to turn to plastic surgery for breast implantation? And, if breast size and shape are so intertwined with definitions of femininity and womanhood, how do women with breast implants make sense of their identity as "feminine" if they experience implant related troubles and complications? (5)

In a case study "that sheds light on the process whereby beliefs about gender interact with prevailing expectations of medicine and science," Zimmerman interviewed 40 women among the one to two million who have implants (13). While this is an admittedly small, self-selected sample (most of her subjects came from support groups or lawyer referrals), the author is absolutely honest throughout about her work and her biases. She believes that despite some epidemiological studies to the contrary, "a link between silicone and disease exists" (13). So, too, do the millions of women who sued the Dow Corning Corporation in the early-1990s, claiming that the company had withheld information linking implants to autoimmune disease and other disorders.

Against a riveting historical background revealing, among other things, that silicone injections into the breast began in Japan after World War II to satisfy American servicemen's desire for large-breasted women, Zimmerman explores the complex influences upon women who elect to have implants. She reports that an alarming 70 percent of women in her study did it because of "interpersonal pressure," or relationship demands. Others yielded to physician pressure as the doctors they consulted deemed them "good candidates," promised higher self-esteem, and gave facile assurances that the surgery was virtually risk free. In a damning passage, the author quotes the American Society of Plastic and Reconstructive Surgeons, which sees small breasts as "deformities [that] are really a disease" (6). Plastic surgeons, she says, "decide which female bodies are 'diseased' and 'in need' of surgical alteration. . . . [T]hey are able to mold and reshape women into 'perfect' images of femininity" (6). She goes on to examine the false expectations that have led women to experience secrecy, denial, depression, illness, and job loss. In one after another poignant testimony she shares the feelings of women like Christine, retired on disability due to physical and cognitive problems, who describes herself as "a chemically toxic person...